Artisan

Marine Artisan Contractor Liability Proposal

A Marine Artisan is an individual or company that provides service or repairs to marine clients such as boatowners, boatyards, marine dealers, etc.. For example, if you repair marine engines, or apply bottom paint you can be considered to be a Marine Artisan.

This insurance primarily provides coverage for small to medium repairers who either work exclusively at one yard or are mobile. In addition you can cover your tools if necessary.

To obtain a quotation please provide us with the following required information:

Preliminary information
Your name
Company Name
Complete Mailing address, City, State/Province, Zip/Postal Code:
(If different) Complete Business address, City, State/Province, Zip/Postal Code:
Telephone
Fax
E-mail
Type of business
Type of business if Other
Years in business
Years experience
Present insurer
Expiration date
Description of operations and gross receipts
Type of work performed	Estimated gross receipts
	Pleasure craft	Commercial vessels
A
B
C
D
Describe types and estimated maximum size & value of vessels repaired

Claims experience-5 years-Insured or Uninsured-If no claims, state "None"
Year	Description	Amount paid/pending	Open or closed

Employee information including owners, partners and officers (if you are a sole proprietor or individual working alone ignore this section)

Full time

Part time

Annual gross payroll

If you use sub-contractors please indicate the percentage of work sub-contracted. If you do not use sub-contractors show "None"
Do you obtain Certificates of Insurance from your sub-contractors?

Percentage of work done at your premises		Percentage of work done at premises of others
Describe all fire and theft protections to protect your property and property of others

Do you assume liability under contract or agreement? If so, please provide details.


List all required Additional Insureds (Name, address, interest)

Limit of insurance required
Proposed effective date of coverage

Important note: Please review entire submission carefully before submitting this form as false information may void your insurance. Submitting this form does not bind you to purchase the insurance or any Insurer to accept the risk, however it is agreed that the information submitted shall be the basis of the quotation and contract should coverage be bound and/or a policy issued. No coverage is bound or in force until confirmed in writing by our office. The information collected from you is used to underwrite coverage and services. This information will be provided to others. .